Study on Patients' Preferences for Anti-diabetic Drugs and the Development of an Evidence-based Decision Aid

Background Diabetes is an important health problem due to its high prevalence and associated disability and mortality. Research evidence provides effective information for improving patient health outcomes. Decision aids can help patients obtain evidence and increase physician-patient interaction. Objective To obtain patients' preferences for anti-diabetic drugs and develop an evidence-based decision aid to achieve the integration of evidence, patient values, and decision settings, thus facilitating patient-centered evidence-based decision making. Methods Several literature databases, like PubMed, Web of Science Core Collection, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), VIP Chinese Science Journals Database, and Wanfang Data were searched to determine the value assessment dimensions and attributes of anti-diabetic drugs. The time limit for literature search is from the establishment of the database to December 31, 2022. The questionnaires for investigating patients' preferences for anti-diabetic drugs were designed using the best-worst scaling method. Then, the empirical study to explore preferences was carried out in five hospitals in Jiangsu Province. Based on the analysis of patients' preferences, an evidence-based decision aid was developed using techniques including Vue + Element UI, Spring Boot, Spring Security, Java, etc. Results The most important five attributes in patient decisions were incidence of macrovascular complications, length of extended life years, change of health-related quality of life, incidence of microvascular complications, and control of HbA1c. The evidence-based decision aid provides a structured summary of evidence on the comparative effectiveness, comparative safety, convenience, and affordability of new anti-diabetic drugs. The multi-attribute value assessment module of new anti-diabetic drugs is the core element of the decision aid, supporting patients' evidence-based assessment of the drugs' value. Conclusion Evidence-based decision aid integrates research evidence of new anti-diabetic drugs, patients' preferences and values, and helps realize shared decision-making between physicians and patients.